Hands of a Woman…Surgeon…

As a junior general surgeon resident, I remember learning from one of my most respected mentors, Dr. Berne, that to be a great surgeon, I must have “the eyes of an eagle, the heart of a lion, and the hands of a woman.” I remember thinking, “Oh good, I am glad I am starting out ahead of the game in at least one out of three areas compared to my male colleagues.” As a practicing pediatric surgeon, I have realized that the medical device industry does not appreciate my hand size as much as I, and maybe my patients, do. Being Asian and at a height of 5’3”, I have generally accepted the fact that my small hands, although possibly a relief for my patients to see, is not the standard hand size device companies think of when they are designing a handheld instrument or equipment for surgical use, and I have made adjustments to work with what is handed to me by the scrub tech. However, I was recently encouraged by some of the online conversation on the American College of Surgeons’ women surgeons’ community discussion. Dr. Tan asked a question as to how women handle the large dials on endoscopy equipment, and within 4 days, 15 responses returned. Everyone had similar complaints about the challenges of using this equipment with small hands, and I was amazed by the multiple, sometimes, complex descriptions of how individuals adapted to their environment in order to effectively and efficiently complete their task. Examples of some of the discussion:

• Don’t let the endoscope settle deep into the crotch between your thumb and first finger…avoid this by periodically gently “tossing” it so that it nestles more against the base of the thumb.
• Position the bed high so you can lean against it.  Cradle the scope, don’t grip it tight, and rotate your hand around a little so you can manipulate the big wheel with your thumb and also reach the buttons on that side
• I hook the scope with the pinkie finger of my left hand. That way the patient cannot push the scope out if they lighten from sedation.
• I used a two handed technique – the left hand holds the large dial/scope head, and the right hand moves the small dial.  The scope itself is held with the pinky and ring finger on my right hand.

I was encouraged by the creativity of the community and how all these bright individuals chose not to allow the limitations of their equipment affect their ability to accomplish great work for their patients. However, in reading this discussion thread, I also realized that the group to which I belong, surgeons with smaller hands (often women), is a growing group of people… and maybe the next time I talk to an equipment rep at a surgical meeting, I should remind them that, although I love the new “toy” that they are showing me, it would be much more sexy if their hand piece actually had the appropriate palm width for someone with a size 6.5 hand. Maybe if they hear this 100 times during a meeting, they would eventually consider the creation of instrumentation customizable to different hand sizes a matter of course.